Individual
MARIE MILDRED MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11-21 BROADWAY ST, GLOVERSVILLE, NY 12078-3968
(518) 725-4310
Mailing address
11-21 BROADWAY ST, GLOVERSVILLE, NY 12078-3968
(518) 725-4310
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NY
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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